Dr David R Wallace Jr, MD - Medicare Diagnostic Radiology in Lake Charles, LA

Dr David R Wallace Jr, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Lake Charles, Louisiana. He went to Louisiana State University School Of Medicine In Shreveport and graduated in 2010 and has 14 years of diverse experience with area of expertise as Diagnostic Radiology. He is a member of the group practice Center For Orthopaedics And Spine, Llc, Gulf Coast Radiology Llc, Paradigm Health System and his current practice location is 1800 Ryan St Ste 105, Lake Charles, Louisiana. You can reach out to his office (for appointments etc.) via phone at (337) 439-4706.

Dr David R Wallace Jr is licensed to practice in Louisiana (license number MD.204718) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1265743595.

Contact Information

Dr David R Wallace Jr, MD
1800 Ryan St Ste 105,
Lake Charles, LA 70601-6078
(337) 439-4706
(337) 439-8110



Physician's Profile

Full NameDr David R Wallace Jr
GenderMale
SpecialityDiagnostic Radiology
Experience14 Years
Location1800 Ryan St Ste 105, Lake Charles, Louisiana
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr David R Wallace Jr attended and graduated from Louisiana State University School Of Medicine In Shreveport in 2010
  NPI Data:
  • NPI Number: 1265743595
  • Provider Enumeration Date: 07/01/2010
  • Last Update Date: 09/20/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 2062727589
  • Enrollment ID: I20160426000183

Medical Identifiers

Medical identifiers for Dr David R Wallace Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1265743595NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology A136122 (California)Secondary
390200000XStudent In An Organized Health Care Education/training Program (* (Not Available))Secondary
2085R0202XRadiology - Diagnostic Radiology MD.204718 (Louisiana)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Specialists Hospital ShreveportShreveport, LAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Center For Orthopaedics And Spine, Llc155779720630
Gulf Coast Radiology Llc65072421952
Paradigm Health System701216246431

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr David R Wallace Jr allows following entities to bill medicare on his behalf.
Entity NameSouth Ryan Mri Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376649061
PECOS PAC ID: 2860396397
Enrollment ID: O20031125000626

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Entity NameOchsner Clinic Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538151428
PECOS PAC ID: 8224933619
Enrollment ID: O20031126000513

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Entity NameRadiology Associates Of Southwest Louisiana
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033215710
PECOS PAC ID: 0941243562
Enrollment ID: O20050606000347

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Entity NameSecond Avenue Mri Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629174339
PECOS PAC ID: 0749203610
Enrollment ID: O20060105000738

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Entity NameParadigm Health System
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780929604
PECOS PAC ID: 7012162464
Enrollment ID: O20130309000011

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Entity NameCenter For Orthopaedics And Spine, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538703335
PECOS PAC ID: 1557797206
Enrollment ID: O20200129000472

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Entity NameGulf Coast Radiology Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1326761925
PECOS PAC ID: 6507242195
Enrollment ID: O20221005002207

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› Verified 7 days ago

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr David R Wallace Jr is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr David R Wallace Jr, MD
1800 Ryan St Ste 105,
Lake Charles, LA 70601-6078

Ph: (337) 439-4706
Dr David R Wallace Jr, MD
1800 Ryan St Ste 105,
Lake Charles, LA 70601-6078

Ph: (337) 439-4706

News Archive

Adding radioimmunotherapy to chemo may help patients with lymphoma

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Read more News

› Verified 7 days ago


Radiology Doctors in Lake Charles, LA

John R Romero Iii, M.D.
Radiology
Medicare: Not Enrolled in Medicare
Practice Location: 1800 Ryan St, Suite 105, Lake Charles, LA 70601
Phone: 337-439-4706    Fax: 337-439-8110
Richard L Martinez, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 1800 Ryan St, Suite 105, Lake Charles, LA 70601
Phone: 337-439-4706    Fax: 337-439-8110
James G Maze, MD
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 1701 Oak Park Blvd, Lake Charles, LA 70601
Phone: 337-494-2121    Fax: 337-494-2360
Donald A Woolridge, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 1800 Ryan St, Suite 105, Lake Charles, LA 70601
Phone: 337-439-4706    Fax: 337-439-8110
Charles J Brdlik, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 1800 Ryan St, Suite 105, Lake Charles, LA 70601
Phone: 337-439-4706    Fax: 337-439-8110
Adam D Olsan, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 1800 Ryan St, Suite 105, Lake Charles, LA 70601
Phone: 337-439-4706    Fax: 337-439-8110

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